Traction fixation appliance for facial bones



March 21, 1939. c H, ALLEN 2,151,458

TRACTION FlXATlON AFPLIANCE'FOR FACIAL BONES Filed Feb. 16, 1938 gnnentor U/m'rZe sJZ/I Z Zen.

Patented Mar. 21, 1939 UNITED STATES TRACTION FIXATION APPLIANCE FACIAL FOR BONES Charles H. Alien, Independence, Mo. Application February 16, 1938, Serial No. 190,769

4 Claims.

This invention relates to traction fixation appliances for facial bones and has for its object to produce means for the immobilization of such bones after a fracture has been corrected by apposition of the bones, under the desired traction, until the knitting process is well under way.

Another object of the invention is to produce a device of the general character set forth which is of universal application so that it may be adjusted to meet fracture conditions through one side of the face as well as fractures through the median line of the face, and is suitable to apply a push as well as a pull on such bones.

A further object of the invention is to produce a device of the general character set forth which is of strong, durable, eflicient and inexpensive construction; and in order that it may be fully understood, reference is to be had to the accompanying drawing, in which:

Figure 1 is a front view of a patient equipped witha traction appliance embodying the invention as it will appear in applying upward pressure or traction to immobilize the bones of the upper part of the face.

Figure 2 is a side view in Figure 1.

Figure-3 is a side view of a modified form of the device such as shown in Figure 1, which is adaptable for applying either a pull or a push on the bones of the face.

Figure 4 is a partial view of the device as shown in Figure 3, but with a traction attachment for the extension of the lower maxillary or mandible.

Figure 5 is a fragmentary detail to indicate one means of preventing longitudinal slippage of the traction lever shown in Figure 3.

In the said drawing, where like reference characters identify corresponding parts in all of the figures, but referring primarily to Figures 1 and 2, a basic or foundation support plate I is fixedly secured in any suitable manner in the plane of the forehead or frontal bone of a patient, said support extending substantially horizontally outward in relation to the forehead. Pivotally mounted as at 2 on the base plate I is a supporting plate member 3 which is provided with a clamp bolt 4 projecting through an arcuate slot 5 in the support I, so that the member 3 may be swung from side to side around a substantially vertical center and locked in position in accordance with the position of the fracture to be treated.

Depending from the outer end of the plate 3 is a rod member 6 threaded for vertical adjustof the device as shown ment through the plate 3 and adapted to be locked in position by means of a lock nut I. Pivoted or fulcrumed to the lower end of the rod 6 is a traction member or lever 8, provided with a longitudinally adjustable extension 9 for projection into the mouth of a patient. The extension 9 carries any suitable type of abutment plate Iii, such as shown of medium hard rubber or the like, for contact with the denture of the patient or to abut the roof of the mouth in accordance with the point where it is desired to apply traction. The end of the lever 8 is slotted for sliding adjustment with the extension 9, the latter being clamped in adjusted position by the bolt l I.

To apply traction on the lever member 8, a rod I2 is vertically adjustable in the plate 3, the lower end of said rod being threaded and extending through the slot in the traction lever. An expansion spring l3 encircles the rod and presses at its underside against the traction lever with a force commensurate with the position of clamping nut l4 threaded on the end of the rod.

Although a cranial cast or the like may be utilized to support the base plate member I, in the preferred construction, it will be rigidly secured to a metal forehead plate I 5, which may be bent to conform to the patients forehead and is suitably padded as at I6, to avoid discommoding the patient. The metal will be of such gauge as to hold its shape against the maximum traction pressure which may be applied on it. This plate I5 is held in fixed position by means of adjustable straps or take-up devices I! extending around the patients head just above the ears, and attached at their rear ends to a second padded metal plate l8, at the base of the back of the head. The two plates are held against downward movement by crossed straps l9 and 20, having take-up buckles or similar fasteners I91; and 20a respectively, the strap [9 extending and resting on the top of the head from front to rear, and the strap 20 extending transversely and having its opposite ends secured to the straps. IT. The assembly is thus of helmet-like nature.

In Figures 3 and 4, a modified form of construction suitable for use with other facial fractures than those of the upper facial bones, is illustrated. This construction in its preferred form involves a forehead plate 2| having downward extensions 22 just in front of a patients ears. This forehead plate 2i is held in fixed position through the cooperative action of a second plate 23 at the back of the head and adjustable clamp straps 24 and 24a respectively, above and described in connectim with Figures 1 and 12.

. Secured permanently or detachably as shown, at the median line of the forehead plate 2 I, is a substantially horizontal base plate member 21. Pivotally secured to the plate 21 and adapted to be swung from side to side and locked by a clamp bolt 28 in an arcuate slot 23, is a downwardly depending support 33. Adjustably secured as by bolt 3| to the downward extension 30 of the forehead plate, is a relatively arch-shaped brace member 32, which has its legs adiustably attached by means of clamp bolts 33 to the downward extensions 22 of the forehead plate. These two members, the downwardly depending member 30 and the arch member 32 form a cage to which various traction devices may be attached. For example, in Figure 3, the depending support 30 is formed with a series of spaced T-shaped slots 34 of proper size to receive a T-shaped traction lever 35, the stem of the T being cut into section 36 which may be pliable or bendable, so

that after the traction member has been longitudinally adjusted, it may be locked by bending the sections 36 on opposite sides of the support 30 so that they will not pass through the T-slots therein. Of course, the traction member could be supplied with locking-pins if preferred. Pressure is applied on the traction member 3 5 by spring 31, attached at one end to the traction lever and at its other end to a horizontal portion 38 in the downward extension member 30, as shown. Tension is adjusted through the nut 39.

In Figure 4, a traction member is shown for applying a pull or extension to the lower maxillary through means of a rod 40 projecting through members 30-32, the end of the rocLbeing threaded and encircled by a spring 4| which is tensioned by a threaded nut 42. In Figure 3, also, a chin or lower mandible supporting plate 43 is illustrated. This plate is adapted to immobilize the mandible and has a .pair of slotted rearwardly projecting straps 44, secured by clamp bolts 45 to the lower ends of a pair of downwardly extending straps 46 secured in adjustable pivoted relation by clamp bolts 41 to the lower ends of the forehead side extension members 22.

From the above description it will be apparent that I have produced a device possessing all of the features of advantage set forth as desirable, and while I have described and fllustrated the preferred construction, it is to be understood that I reserve the right to make all changes within the spirit of the invention and without the ambit of the prior art.

I claim:

1. In a traction fixation appliance for facial bones, a base member adaptedto be fixedly secured to the forehead of a patient, a support in dependent relation to said base and having its lower end spaced in front of the patient, and a traction lever for upper maxillary bones fulcrumed at its outer end to said support, the inner end of the lever being adapted to swing arcuately upward to apply traction to the upper maxillary of the patient.

2. In a traction fixation appliance for facial bones, a base member adapted to be'flxedly secured to the forehead of a patient, a support in dependent relation to said member and having its lower end spaced in front of the patient, a traction lever for upper maxillary bones fulcrumed at its outer end to said support, the

inner end of the lever being adapted to swing arcuately upward to apply traction to the upper maxillary of the patient, and means for applying yielding pressure tending to swing the traction lever.

3. In a traction fixation appliance for facial bones, a base member adapted to be fixedly secured to the forehead of a patient, a forwardly projecting plate pivoted to the base member at one end so that its outer end may oscillate in a substantially horizontal plane, a support in dependent relation to said plate and having its lower end spaced infront of the patient, means to lock the plate in adjusted position, a traction lever for upper maxillary bones fulcrumed at its outer end to said support, the inner end of the lever being adapted to swing arcuately upward to apply traction to theupper maxillary of the patient, and means for applying yielding pressure tending to swing said traction lever around its fulcrum.

4. In a traction fixation appliance for facial bones, a base member adapted to be fixedly secured to the forehead of a patient, a forwardly projecting plate pivoted to the base member for oscillation at its outer end in a substantially horizontal plane, a clamp bolt carriedby the plate and extending through an arcuate slot in the base member for clamping the plate in adjusted position, a support depending from the outer end of the plate, a traction lever for upper maxillary bones fulcrumed at its outer end to the lower end of said support, and means for applying yielding pressure tending to swing the lever upwardly around its fulcrum.

CHARLES H. ALLEN. 

